title: Optimal site for atrial lead implantation in myotonic dystrophy patients: the role of Bachmann's Bundle stimulation.
abstract: OBJECTIVE
  The aim of this study was to identify the optimal site for atrial lead implantation in myotonic dystrophy type 1 (MD1) patients.
  
  
  METHODS
  The atrial pacing lead was positioned in the high-lateral right atrial wall (site A), then in the right atrial appendage (site B), and finally on the interatrial septum (site C) in 22 patients. Pacing and sensing thresholds were obtained for all sites. The lead was repositioned and fixed at the optimal site, defined as the location with the lowest pacing and the highest sensing thresholds.
  
  
  RESULTS
  Mean pacing thresholds were 1.46 +/- 0.32 V at site A, 1.45 +/- 0.33 V at site B, and 0.84 +/- 0.24 V at site C. P-wave amplitude was 1.52 +/- 0.45 mV at site A, 1.52 +/- 0.49 mV at site B, and 2.60 +/- 0.48 mV at site C. Atrial lead was implanted at site C in all patients without complications.
  
  
  CONCLUSIONS
  Interatrial septum in the region of Bachmann's Bundle seems to be the optimal site for atrial lead implantation in MD1 patients.
authors.affiliation: Chair of Cardiology, Second University of Naples-Monaldi Hospital, Naples, Italy.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Nigro
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Russo
authors.forename: Pasquale
authors.initials: P
authors.lastname: Vergara
authors.forename: Antonello
authors.initials: A
authors.lastname: D'Andrea
authors.forename: Grazia
authors.initials: G
authors.lastname: Di Gregorio
authors.forename: Luisa
authors.initials: L
authors.lastname: Politano
authors.forename: Giovanni
authors.initials: G
authors.lastname: Nigro
authors.forename: Raffaele
authors.initials: R
authors.lastname: Calabrò
mesh_terms: D000328:Adult; D004567:Electrodes, Implanted; D005260:Female; D006325:Heart Atria / Q000601:surgery*; D006333:Heart Failure / Q000175:diagnosis* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D009223:Myotonic Dystrophy / Q000175:diagnosis* / Q000628:therapy*; D010138:Pacemaker, Artificial; D019919:Prosthesis Implantation / Q000379:methods*; D016896:Treatment Outcome